胃肠道手术麻醉患者术中目标导向液体疗法的效果。

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY World Journal of Gastrointestinal Surgery Pub Date : 2024-09-27 DOI:10.4240/wjgs.v16.i9.2815
Jun Zhang, Xiao-Wen Li, Bing-Feng Xie
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引用次数: 0

摘要

背景:术中液体管理是胃肠道手术麻醉管理的一个重要方面。术中目标导向液体疗法(GDFT)是一种通过实时监测和调节液体输入来优化患者生理状态的方法:本研究采用回顾性对比研究设计,纳入了在一家医院接受胃肠道手术的 60 名患者。实验组(GDFT 组)和对照组各 30 名患者分别接受术中 GDFT 和传统液体管理策略。通过比较两组患者的术后恢复情况、并发症发生率、住院时间等指标来评估 GDFT 的效果:实验组和对照组的术中失血量分别为(296.64 ± 46.71)毫升和(470.05 ± 73.26)毫升(P < 0.001),尿量分别为(415.13 ± 96.72)毫升和(239.15 ± 94.69)毫升(P < 0.001)。实验组术后恢复时间为(5.44 ± 1.1)天,对照组为(7.59 ± 1.45)天(P < 0.001)。实验组的住院时间为 10.87 ± 2.36 天,对照组为 13.65 ± 3 天(P < 0.001)。实验组和对照组在术后 24 小时和 48 小时的视觉模拟量表评分分别为(3.38 ± 0.79)和(4.51 ± 0.86),以及(2.05 ± 0.57)和(3.51 ± 0.97)(P < 0.001)。实验组和对照组的心输出量分别为 5.99 ± 1.04 L/min 和 4.88 ± 1.17 L/min,两组的脉压变异率分别为 10.87 ± 2.36% 和 17.5 ± 3.21%:在胃肠道手术中应用 GDFT 可显著改善术后恢复,降低并发症的发生率,缩短住院时间。
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The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery.

Background: Intraoperative fluid management is an important aspect of anesthesia management in gastrointestinal surgery. Intraoperative goal-directed fluid therapy (GDFT) is a method for optimizing a patient's physiological state by monitoring and regulating fluid input in real-time.

Aim: To evaluate the efficacy of intraoperative GDFT in patients under anesthesia for gastrointestinal surgery.

Methods: This study utilized a retrospective comparative study design and included 60 patients who underwent gastrointestinal surgery at a hospital. The experimental group (GDFT group) and the control group, each comprising 30 patients, received intraoperative GDFT and traditional fluid management strategies, respectively. The effect of GDFT was evaluated by comparing postoperative recovery, complication rates, hospitalization time, and other indicators between the two patient groups.

Results: Intraoperative blood loss in the experimental and control groups was 296.64 ± 46.71 mL and 470.05 ± 73.26 mL (P < 0.001), and urine volume was 415.13 ± 96.72 mL and 239.15 ± 94.69 mL (P < 0.001), respectively. The postoperative recovery time was 5.44 ± 1.1 days for the experimental group compared to 7.59 ± 1.45 days (P < 0.001) for the control group. Hospitalization time for the experimental group was 10.87 ± 2.36 days vs 13.65 ± 3 days for the control group (P < 0.001). The visual analogue scale scores of the experimental and control groups at 24 h and 48 h post-surgery were 3.38 ± 0.79 and 4.51 ± 0.86, and 2.05 ± 0.57 and 3.51 ± 0.97 (P < 0.001), respectively. The cardiac output of the experimental and control groups was 5.99 ± 1.04 L/min and 4.88 ± 1.17 L/min, respectively, while the pulse pressure variability for these two groups was 10.87 ± 2.36% and 17.5 ± 3.21%, respectively.

Conclusion: The application of GDFT in gastrointestinal surgery can significantly improve postoperative recovery, reduce the incidence of complications, and shorten hospital stays.

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